Health Professionals Follow-up Study: Prospective Studies of Diet and Cancer in Men and Women

Walter C. Willett, M.D., M.P.H., Dr.P.H.
Harvard School of Public Health, Department of Nutrition, Boston, Mass.
Funded since 1991
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The grant provides for continued follow-up for and research on the Health Professionals Follow-up Study of 51,529 men who completed an extensive dietary questionnaire first in 1986 and again in 1990, 1994, and 1998. This research endeavor has contributed substantially to information on diet and cancers of the breast, prostate, colon, and bladder.

In this grant, prospectively collected dietary data and froze plasma and DNA specimens are being used to address a series of hypotheses regarding major cancers in men and women. These nutritional and genetic exposures also are being examined in relation to specific molecular characteristic of tumors. Cancer sites under study include prostate, colon and rectum, bladder, lung, kidney, and ovary.

Investigators are extending and refining observations from the first 12 years of follow-up of the Health Professionals Follow-up Study, and are addressing new hypotheses related to both cancer incidence and survival:

• Project 1 examines dietary (lycopene, calcium, and N-3 fatty acid intakes) and other predictors of prostate cancer incidence in relation to risk of relapse among men with apparently successful treatment for localized prostate cancer. In addition, a series of dietary and hormonal factors will be relate to specific characteristics of incident cancers, including expression of PTE and COX-2 and markers of angiogenesis.
• Project 2 addresses hypotheses relating intakes of folic acid, calcium, and red meat, and plasma levels of insulin-like growth factor (IGF)-1and its binding proteins to risks of both colorectal cancer and adenomas. Interactions with germline polymorphisms and relationships with specific molecular tumor characteristics will be examined.
• Project 3 examines dietary and related risk factors for bladder cancer in both men and women. Exposures include intakes of cruciferous vegetable and total fluids, and biochemical indicators of selenium and arsenic exposure. Interactions with polymorphisms in carcinogen metabolizing genes and specific association with p53 expression in tumors also will be examined.
• Project 4 pools data from all 11 major published prospective studies of diet and cancer. Precise and unique information has already been obtained for breast, lung, and colon cancers, and analyses will be extended to cancers of the pancreas and ovary.

These highly interrelated studies that integrate dietary factors, established non-dietary risk factors, endogenous hormone levels, genetic susceptibility and molecular characteristics of tumors, will contribute to the understanding and prevention of the major cancers of men and women.